Health care: A provider's perspective

[Jackpine Radical]

I have largely bailed out of providing conventional mental health services in favor of criminal forensic evaluations, mostly out of the frustrations involved in dealing with insurance companies. The small clinic where I work has a specialist who spends most of her time wrangling with insurance companies trying to get authorizations for needed treatment and fighting them after they have denied payment after the fact, made only a partial payment, "lost the paperwork," or committed some other egregious violation of common decency to avoid paying us. And all this, of course, after having blackmailed us into contracts to provide services at ruinously low rates of compensation.

Anyway, I was sitting around talking to some other people in the clinic about what we might expect as a consequence of the health care bill. Pretty much universally, we agreed that the pay rates will continue downward to Medical Assistance levels (which are about 1/4 of normal rates), and there will be no enforcement mechanism in the system to make them actually pay even the dismally low rates to which they will have driven us. I can guarantee the clinic will not survive under those conditions. Insurance companies already hate psychotherapy because it's "too expensive" when they would rather get by with suppressing the symptoms with psychoactive medications rather than pay for people to get help in confronting and coping with their life issues, so nobody but our hapless patients will mourn our passing. At least until their new happy pills kick in.

[nightrain]

1. knr. Yep, that's close to my perspective as a practitioner also.... terribly sad, isn't it?